The use of estimated glomerular filtration rate in the evaluation of renal function in HIV-positive children in Enugu

Background: Glomerular filtration rate (GFR) is a measure of renal function that estimates the volume of fluid filtered from the renal glomerular capillaries. An assessment of renal function in HIV-positive children is timely due to the high prevalence of HIV-associated nephropathy (HIVAN) in HIV-positive children that progresses to end-stage renal disease (ESRD). Objectives: To estimate the glomerular filtration rate using creatinine-based Schwartz formula. To determine the renal function in HIV-positive children in UNTH, using the estimated glomerular filtration rate (eGFR). Materials and Method: A total of 159 HIV-positive children had serum creatinine estimation and GFR calculated using the Schwartz formula. Values of eGFR of 2SD below the normal for age and gender as determined by National Kidney Foundation (NKF) were taken as low renal function. Results: There were 80 males and 79 females enrolled. The mean eGFR for the study population was 109.44 +/- 16.86 mls/min/1.73m(2). Ninety children (56.6%) had normal renal function while 69 (45.4%) had low renal function for their respective age groups. Those with low renal function were older (P < 0.001) and had lower CD4 cell counts (P = 0.01). The eGFR was inversely related to age (r = - 0.30, P = < 0.001) and directly related to CD4 cell count ( r = 0.30, P = < 0.001). Conclusion: There is derangement in renal function among HIV-infected children as seen from their eGFR.